Imagine a healthcare system where cancer patients face longer waits and reduced access to life-saving treatments, not because of a lack of technology, but due to a shortage of qualified professionals. This is the stark reality facing Ireland's cancer care services, as revealed at a recent Siptu conference. The Health Service Executive (HSE)'s failure to recruit this year's radiography and radiation therapy graduates has left two critical areas of cancer care understaffed, exacerbating existing waiting list challenges. But here's where it gets even more concerning: despite a previous commitment to offer positions to all graduating radiographers and radiation therapists (approximately 120 and 40, respectively), the HSE's Pay and Numbers Strategy has effectively blocked these hires, deepening the staffing crisis.
Delegates at the Galway conference unanimously passed a motion demanding better resourcing for public healthcare workers and services. Michele Monahan, a senior radiographer and Siptu representative at a major public hospital, bluntly stated, “We’re drowning in work because we simply don’t have enough staff. The Pay and Numbers Strategy has been devastating for us.” The strategy, implemented to freeze staffing levels as of December 31, 2023, by eliminating vacant positions, has had unintended but severe consequences.
And this is the part most people miss: by September, roughly a third of newly qualified diagnostic radiographers remained unemployed, with many likely lost to the private sector or emigration. Debbie Kelleher, a radiation therapist and Siptu representative at another public hospital, highlighted the disparity: “Out of 30 radiation therapists who qualified this year, only 10 secured positions initially, 10 were placed on waiting lists, and 10 were left jobless. Meanwhile, cancer treatment machines sit underutilized or even idle.”
Both Monahan and Kelleher argue that all graduates could—and should—have been hired to address the staffing shortages. They view the HSE’s decision as a false economy, as the underutilization of expensive diagnostic equipment forces the system to outsource more services to the private sector, ultimately costing more in the long run. Is this a sustainable approach to healthcare?
Monahan also pointed out a vicious cycle: existing shortages drive burnout and poor work-life balance, pushing professionals to leave the system. “Many say they’ll seek other opportunities to escape the relentless pressure,” she explained. Kevin Figgis, Siptu’s senior health sector official, traced the problem back to the Pay and Numbers Strategy, which he believes prioritizes budget control over patient care.
The HSE defends its decision, claiming it was necessary to rein in a consistently overspent staff budget. They assert that significant hiring has continued in key areas. However, negotiations between the HSE and unions at the Workplace Relations Commission persist, with the next meeting scheduled for next week. Unions argue that there are 6,000 unfilled vacancies across the public health sector, a figure the HSE disputes.
Here’s the controversial question: Is the HSE’s focus on budget regularization compromising the quality and accessibility of cancer care? And if so, what should be done to balance fiscal responsibility with the urgent need for healthcare professionals? We’d love to hear your thoughts in the comments below.
